Left Ventricular Layer-Specific Myocardial Strains in Children with Recovered Primary Dilated Cardiomyopathy: What Lies Beneath the Iceberg?
- 45 Downloads
We aimed to detect residual cardiac dysfunction—if any—in children with recovered primary dilated cardiomyopathy (DCM) by using the left ventricular (LV) layer-specific myocardial strains. Fifty children with recovered primary DCM both clinically and echocardiographically were included as the patient group. Fifty healthy children of matched age and sex served as the control group. Echocardiographic evaluation was performed for all included children in the form of conventional echocardiography, tissue Doppler imaging (TDI), two-dimensional speckle tracking echocardiography (2D-STE), and LV layer-specific myocardial strain. Both LV systolic and diastolic functions measured by conventional echocardiography were similar in children with recovered DCM and the control group. There was a significant reduction in LV systolic and diastolic functions measured by TDI in the patient group. Moreover, there was a significant reduction of LV global longitudinal systolic strain (GLSS) by 2D-STE in children with recovered DCM. Interestingly, there was a significant reduction of LV layer-specific myocardial strain from endocardium to epicardium in children with recovered DCM compared to the healthy control. There was a significant positive correlation between different layer-specific myocardial strains and LV GLSS, LV ejection fraction, and LV peak systolic velocity. Left ventricular layer-specific myocardial strain can be a promising tool for early identifications of LV dysfunction in children with DCM. Subtle cardiac dysfunction is present in patients with recovered DCM, so long-term follow-up is recommended in these patients.
KeywordsDilated cardiomyopathy Children Layer-specific strain
Compliance with Ethical Standards
Conflict of interest
All authors have no potential conflict of interest to disclose.
The study is in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki declaration and its later amendments.
- 2.Alvarez JA, Orav EJ, Wilkinson JD, Fleming LE, Lee DJ, Sleeper LA, Rusconi PG, Colan SD, Hsu DT, Canter CE, Webher SA, Cox GF, Jefferies JL, Towbin JA, Lipshultz SE, Pediatric Cardiomyopathy Registry Investigators (2011) Competing risks for death and cardiac transplantation in children with dilated cardiomyopathy: results from the Pediatric Cardiomyopathy Registry. Circulation 124:814–823CrossRefGoogle Scholar
- 4.Everitt MD, Sleeper LA, Lu M, Canter CE, Pahl E, Wilkinson JD, Addonizio LJ, Towbin JA, Rossano J, Singh RK, Lamour J, Webber SA, Colan SD, Margossian R, Kantor PF, Jefferies JL, Lipshultz SE (2014) Recovery of echocardiographic function in children with idiopathic dilated cardiomyopathy: results from the pediatric cardiomyopathy registry. J Am Coll Cardiol 63(14):1405–1413CrossRefGoogle Scholar
- 5.Alexander PM, Daubeney PE, Nugent AW, Lee KJ, Turner C, Colan SD, Robertson T, Davis AM, Ramsay J, Justo R, Sholler GF, King I, Weintraub RG (2013) Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: results from a national population-based study of childhood cardiomyopathy. Circulation 128:2039–2046CrossRefGoogle Scholar
- 10.Ozawa K, Funabashi N, Takaoka H, Kamata T, Kanaeda A, Saito M, Nomura F, Kobayashi Y (2015) Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique. Int J Cardiol 184:237–243CrossRefGoogle Scholar
- 11.Bogdanović J, Ašanin M, Krljanac G, Lalić NM, Jotić A, Stanković S, Rajković N, Stošić L, Rasulić I, Milin J, Popović D, Bogdanović L, Lalić K (2019) Impact of acute hyperglycemia on layer-specific left ventricular strain in asymptomatic diabetic patients: an analysis based on two-dimensional speckle tracking echocardiography. Cardiovasc Diabetol 18:68CrossRefGoogle Scholar
- 13.Lai WW, Geva T, Shirali GS, Task Force of the Pediatric Council of the American Society of Echocardiography, Pediatric Council of the American Society of Echocardiography (2006) Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 19(12):1413–1430CrossRefGoogle Scholar